Health Department Launches Take Care New York 2020, a Comprehensive Blueprint for Improving the Health of All NY’ers

Take Care New York 2020 process will include unprecedented community engagement: community members will rank and prioritize health indicators for their neighborhood that they want to focus on and improve

The Health Department today launched Take Care New York 2020, the city’s comprehensive health blueprint to give all New Yorkers a chance to live a healthier life. Take Care New York (TCNY) 2020 identifies key areas for health improvement across the City and for advancing health equity. The Health Department’s aim is twofold: to improve the health of all New York City communities, and to promote even greater strides in groups that today have the worst health outcomes. Many of the indicators included in the document have both citywide target and equity focus. The latter pays special attention to narrowing the gap between the groups with the best health outcomes in comparison to the citywide averages. Additionally, the effort will involve unprecedented community engagement – neighborhood residents will be able to vote on the indicators for which they would like to see the greatest focus. Unlike previous iterations, TCNY 2020 includes indicators to include areas that affect health such as education, housing and violence. This broader focus recognizes that such factors often are more important drivers of health outcomes than individual behaviors. As such, TCNY 2020 addresses not only health behaviors and health outcomes, but also includes non-traditional indicators like neighborhood high school graduation and incarceration rates. The goal is to create a broader picture of neighborhood wellbeing. The Commissioner was joined at Brooklyn Public Library’s Central Library by First Deputy Commissioner Dr. Oxiris Barbot, Borough President Eric L. Adams, Brooklyn Public Library President and CEO Linda E. Johnson, and Colvin W. Grannum, President & Chief Executive Officer of the Bedford Stuyvesant Restoration Corporation. Materials related to Take Care New York 2020 can be found at the agency’s website, nyc.gov/health

“Take Care New York 2020 outlines a comprehensive blueprint for improving the lives of all New Yorkers and addressing inequities – the health gaps that occur across many indicators – that we see in our data,” said Health Commissioner Dr. Mary T. Bassett. “Some of these inequities are glaring: in 2012, Black women in New York City were more than 10 times as likely as white women to die in childbirth, and, while we have made tremendous progress in reducing infant mortality in New York City, the rate is almost 3 times higher for Black babies as compared to White ones. As part of this effort to make New York City healthier, Take Care New York 2020 will launch a community driven process to look at all the indicators and prioritize the ones to focus on for each neighborhood. It will take every New Yorker and every neighborhood working together to improve health.”

“The reason we are here at Brooklyn Public Library today is that neighborhoods, communities, and residents play a vital role in shaping the Take Care New York 2020 process,” said First Deputy Commissioner Dr. Oxiris Barbot. “TCNY 2020 is not just about what the Health Department will do to make communities healthier, but rather how all parts of our city have a role to play in making our communities healthier. Our community consultations will be held at libraries and other community focal points across the five boroughs. In every community we will ask participants to consider what indicators are important to them – and decide on what they want to advance the health of their community. The Health Department will work with every community to leverage city and community resources to ensure measurable change. Every neighborhood deserves to be the healthiest it can be– and it starts with the people in that neighborhood and government working together.”

"Our neighborhoods have received the diagnoses of the public health challenges they face, and now we must provide the treatment plans to solve them,” said Brooklyn Borough President Eric L. Adams. “I look forward to working with Commissioner Bassett and the Health Department on Take Care New York 2020 and other efforts that address local inequities and work with communities on reversing them. Nothing can be more important than creating safer places to raise healthy children and families in Brooklyn and across New York City."

“Brooklyn Public Library offers free health services throughout our sixty branches, including exercise classes, wellness counseling and Positive Aging programs,” said Brooklyn Public Library President and CEO Linda E. Johnson. “As a trusted civic institution with a presence in every Brooklyn neighborhood, we are proud to participate in the TCNY 2020 effort to achieve health equity in New York City.”

“The Restoration Corporation strongly believes that one's zip code should not determine one's life outcomes,” said Bedford Stuyvesant Restoration Corporation President and CEO Colvin W. Grannum. “The aspiration for an equitable city requires everyone to advocate for the systemic changes that level the playing field in critical areas such as health. We thank Commissioner Basset for her leadership in Take Care NY 2020, an ambitious effort to address the glaring health disparities that disproportionately impact low income communities of color. The plan’s early and ongoing engagement of residents has the potential to create lasting, community-wide change while improving the overall wellbeing of individual families.”

In planning for TCNY 2020 the agency reviewed current data on diseases and deaths in New York City, looking for trends that unjustly affect some neighborhoods and/or populations more than others. Where data were available levels, the agency looked for inequities along such dimension as age, race/ethnicity, gender, education, neighborhood poverty, immigration status, borough and sexual orientation. An equity focus was selected for those comparisons that showed the largest gaps.

With input from national and international public health experts, the Health Department narrowed its focus to indicators that could be traced back to underlying drivers of inequities such as housing, economics and education, and that also hold promise for improvement by the target year of 2020. These leading indicators were then grouped into four priority focus areas for targeted intervention. The four focus areas are:

Promote Healthy Childhoods

Create Healthier Neighborhoods

Support Healthy Living

Increase Access to Quality Care

For most indicators there are separate citywide and equity focus. The equity focus pays special attention to narrowing the gap between the groups with the best health outcomes in comparison to the citywide average. For example, the “Self-reported Health Status” indicator, which measures the percentage of adults who report their health is ‘excellent,’ ‘very good,’ or ‘good,’ has a citywide target of 82 percent, a 5 percent increase from the baseline of 77 percent. It also has an equity focus for Hispanics, who have the lowest self-reported health status across the city. For Latinos, the goal is to move those who report their health is ‘excellent,’ ‘very good,’ or ‘good,’ from 68 percent to 73 percent. For some indicators fundamental to community wellness, such as social cohesion, were retained even though data will not be available until next year.

Focus Areas and Indicators Many of the indicators included in the document have both citywide target and equity focus. The latter pays special attention to narrowing the gap between the groups with the best health outcomes in comparison to the citywide averages.

Promote Healthy Childhoods Indicators:

Babies Born in “Baby-Friendly facilities”

Openings in Child Care Centers

Equity Focus: Very high-poverty neighborhoods

Teenage Pregnancy

Equity Focus: Very high-poverty neighborhoods

High School Graduation

Create Healthier Neighborhoods Indicators:

Assault Hospitalizations

Equity Focus: Very high-poverty neighborhoods

Seniors Fall-related Hospitalizations

Staten Island

Air Quality

OneNYC goal is to achieve the best air-quality ranking among major cities by 2030.

Homes with No Maintenance Defects

Equity Focus: Very high-poverty neighborhoods

Children’s Visits to Emergency Departments for Asthma

Equity Focus: Very high-poverty neighborhoods

Jail Population

OneNYC goal is to decrease the average daily population in jail.

Social Cohesion

Support Healthy Living Indicators:

Obesity

Equity Focus: Very high-poverty neighborhoods

Sugary Drinks

Equity Focus: Blacks and Hispanics

Physical Activity

Equity Focus: Asian-Pacific Islanders

Sodium Intake

Equity Focus: Blacks

Smoking

Equity Focus: High School Graduates

Binge Drinking

Equity Focus: 18 to 24 year olds

Overdose Deaths

Equity Focus: Very high-poverty neighborhoods

Increase Access to Quality Care Indicators:

Unmet Mental Health Need

Equity Focus: Very high-poverty neighborhoods

Unmet Medical Need

Equity Focus: Hispanics

Controlled High Blood Pressure

Equity Focus: Blacks

New HIV Diagnoses

Equity Focus: Black and Hispanic MSM

HIV Viral Suppression

Equity Focus: Blacks

Unprecedented Community Consultation Process Take Care New York 2020 involves the community like never before. The Health Department is embarking on a process that is place-based and supports the development of localized action plans. The action plans will be focused on health issues identified as top priority by residents of the local area during community consultations held this fall and winter. Community members will be invited to forums, held at multiple neighborhoods within each borough, during which DOHMH will share data on citywide and local health issues and engage with the community in a conversation about local health priorities and assets available to advance the priorities. The forum occurs this evening at the Bedford Public Library from 5 p.m. to 7 p.m.

At each community consultation, the Health Department will present an overview of TCNY 2020, including local health data with emphasis on inequities and locally- relevant health burden. Residents will be led in a discussion about the data presented, its relative importance of indicators presented, and existing neighborhood assets and initiatives in the community that can support the advancement of TCNY. Residents will then be asked to respond and rank TCNY 2020 indicators.

Following the consultations the Health Department will report back to residents with a report that outlines the issues of greatest interest and concern to residents. The agency will then work with community-based organizations and residents to develop a localized action plan to address the identified issues. The agency will also issue a report in spring 2016 recommending evidence-based interventions to help advance community priorities. Simultaneously, the agency will engage sister agencies, the healthcare community, employers, and other organizations to support neighborhood health priorities.

Community Health Profiles A Community Health Profile is being produced for every community district in the city, and will be used extensively in the Take Care New York 2020 community consultation process. Every Profile begins with a “Who We Are” section, which outlines the population in that district with a breakdown by ethnicity and age. Further, it includes the percentage of those who reported their own health as ‘excellent,” very good,” or “good,” and the life expectancy of residents in that district. The Profile is then broken down into five data sections. For reference, each data point is compared to the best performing community district, the borough, and New York City as a whole. The Community Health Profiles can be found at the agency’s website, nyc.gov/health.

Take Care New York First launched in 2004, Take Care New York initially identified 10 steps New Yorkers could take to improve their health. Building upon the successes of this, Take Care New York 2012 was launched in 2009 with a new set of 10 priorities, selected for their public health importance and potential for improvement, together with strategies for improvement and measurable goals.